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We know efforts of the Republican party to repeal and replace the Affordable Care Act (ACA) have failed. What we don’t know is what healthcare legislation (if any) will ever get through both chambers of Congress and into the hands of President Donald Trump to sign into law. That’ll remain a mystery for the foreseeable future, but passing a law isn’t the only way the ACA can be altered. There’s also regulatory action that can occur.
“The Secretary shall…” or “The Secretary may…” are phrases referenced in the context of the ACA 1,442 different times. This so-called Secretary is the head of the Department of Health and Human Services (HHS)—Tom Price. These citations give Price the power to interpret how certain ACA provisions should be implemented, and surely Price will do things differently than previous HHS Secretaries appointed under the Obama administration.
Price has been a long-time opponent of the ACA. He even introduced his own version of a repeal bill back in 2015 when he was a Senator. Price has also gone on record to say that he plans to review every provision he can change.
Changes through regulatory action have already begun. The enforcement of the Individual Mandate was eased earlier this year when an announcement was made that tax returns would be accepted without insurance status included. The upcoming open enrollment period in the individual market was shortened to a 45-day period, and stricter enforcement of special enrollment periods are now under way.
Price might try to ease requirements on employers next. Under the Obama administration, regulatory action delayed the Employer Mandate—then phased in the requirements over a two-year period. There’s been some suggestions that Price will reevaluate whether prescribed contraceptives must be covered as a no-cost preventive benefit for women.
We’re still in store for a slew of changes even though Congressional efforts to repeal and replace the ACA have not been successful so far.
It’s not a matter of if regulatory change will occur or not, it’s a matter of what will change and when it will happen.
